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Re: So confused about weight gain. Dr vs. IBCLC

What I don't understand is why supplementing started at 1 month old, as baby's weight gain seemed to have become normal at that point?
When you started supplementing, did you/do you always pump each time you supplement (approximately) to 'make up' for that supplemental feeding?
Also- how often does your baby nurse? When I hear a mom whose baby is not gaining well say "she's a good sleeper' that makes me suspect baby is not being brought to the breast with enough frequency. This could be due to baby not cueing enough, but then it’s important for mom to not wait for cues and go ahead and offer/gently encourage more nursing. Even short nursing sessions help, its the frequency of the milk removal that is most important. If baby absolutely will not nurse any more frequently, then pumping with a very good pump frequently is the next best thing, but not nearly as effective as a baby in most cases.
Milk supply is dependant on demand. Whenever a mom supplements and/or baby does not nurse often enough, she runs the risk of diminishing milk production. The way to build it back up is with frequent effective nursing and pumping as needed. Plus galactagogues if you want.

I strongly suggest the book Making More Milk. Kellymom.com also has excellent info on increasing milk production. Based on your baby’s history, it is very likely you did not have some pre-existing condition harming milk production, as it appears the initial issue was the tongue tie. So, like the vast majority of mothers, in all likelihood your body is perfectly capable of making enough milk, you have just been taken off track by first the tongue tie and then the supplementing.

Re: So confused about weight gain. Dr vs. IBCLC

Thanks, ladies.

What I meant by "she's a good sleeper" is that I can generally nurse her and/or give her a tiny supplement, lay her down and she will drift off to sleep on her own for an hour or so during the day and from about 8pm to 1am at night. This makes me feel like she is somewhat satisfied with the amount of milk she is getting. I feel like if she was perpetually hungry, she would wake up, alarmed that the boob wasn't in her mouth anymore.

As far as why I started supplementing, there are 2 factors:

1. Lack of confidence/trust in my body from previous history. My first girl had undiagnosed tongue tie and was diagnosed with FTT at one month. I saw my second girl's big drop in weight after those first few days and panicked. I would top her off during her fussy times at night. i know it was not the right thing to do but, it was how I handled it at the time. I quickly found and IBCLC, got her tongue clipped and EBF for about 3 weeks. At that time, she only gained 1 oz per week so, I was told to supplement 2 oz or so per day to get the gaining back up to 5 oz per week. I also got on domperidone.

2. Pain. My nipples were so shredded and I was so exhausted by the end of the day. A lot of times my husband would give her the bottle and I would just go soak myself and my boobies in a warm tub. I couldn't bear to pump either because it was so painful so, she got formula.

I could definitely stand to put her to the breast more but, right now, she will not stay latched for more than 2-3 mins. So, it's a game of putting her on, her popping off, etc until she either a.) gets pissed and I give her a bottle or b.) I finally have a let-down and she will switch nurse for 30 mins or so. I probably put her to the breast 9-10 times during a 24 hour period.

At this point, my confidence is low and I have very little faith that I can get off these supplements. I'm just being honest. My IBCLC is not responding to my emails and I am off domperidone which I feel like is sort of the death nail for EBF. I came here for a cheerleader. I just have no faith that I can give my baby what she needs with out a "backup". And I am so exhausted with "the dance".

Re: So confused about weight gain. Dr vs. IBCLC

Greetings LOUMOM!,
You are in need of a cheerleader!? you are a brave and determined struggling mother! I am cheering for you.
You are nursing 9 or more times a day! that is fabulous. You have nursed your precious child even though your nipples are traumatized! How much more could a mother put her infant's needs ahead of her own?
You know deep in your heart that breastfeeding is supposed to be pleasurable for you and your baby.
you know there is a pathway to that goal but so much extraneous debris is blocking your path.
Of course you are feeding your infant a supplement! You are a good mother intune to the needs of your baby and if she is not getting what she needs from nursing she must be fed.
Good mothers are in tune to what their baby's need.
I have seen mothers increase their supply and heal their nipples and use their own expressed milk to feed the baby by learning how to
hand express.
hand expressing prevent any contact with the nipple b/c the breast is milked, the nipples are not touched. milk can be collected in any clean container and fed to the baby in a bottle.
when you are ready to put the baby to the breast, you might want to try feeding her an ounce or so of the expressed milk/supplement first and then tempt her to latch.
rather than have her frustrated/exhausted from an unsatisfying attempt to nurse and then give a bottle...switch the process around. Supplement first and then nurse.
If you breasts have been primed from all the good healing hand expressing your daughter will be rewarded for her efforts with a plentiful milk supply.
aim for 10-12 times a day for hand expressing.
Good luck.

Re: So confused about weight gain. Dr vs. IBCLC

if my pp seemed somehow unsupportive, I truly apologize, that was not my intent. I asked the questions I did as I was trying to understand the situation better. Also i frequently suggest mommas try to nurse more often, even if its just one more time a day, because imo more frequent nursing helps in almost every situation.

your initial post asked if your baby was gaining too slowly, and ‘2. if so, can I do something about it that doesn't involve more formula?!?’

Many tried to answer your question about the weight gain, although of course that is really a medical ?. The second query, I took to mean, that you were looking for suggestions for increasing supply/moving toward eping. That is what I and some others tried to provide.
You are not alone. Many moms find themselves in a position where, for a variety of reasons, they supplement in the early days and it affects production down the road. And yes, it does take effort to bring back a normal production. And yes, lack of confidence is a great undermining factor when it comes to moving away from supplements!

that is why I said, Based on your baby’s history, it is very likely you did not have some pre-existing condition harming milk production, as it appears the initial issue was the tongue tie. So, like the vast majority of mothers, in all likelihood your body is perfectly capable of making enough milk, you have just been taken off track by first the tongue tie and then the supplementing.

Whether or not you ultimately are able to exclusively breastfeed is unknowable of course. But yes, generally speaking it is certainly possible, many moms have increased milk production many months down the line.

The weight gain does seem slow at this point. But if your baby is otherwise healthy, is that really a problem? I cannot answer that. Perhaps you need to have a more in depth discussion with your baby’s pediatrician, or seek another medical opinion, since you are getting conflicting opinions from the pediatrician vs. the ibclc. It also appears –and I am sorry if I have this wrong- that the more you supplement, the more slowly baby gains. That raises some questions I would not even begin to speculate about.

If the fact is your baby is not getting enough milk at the breast, I don’t know if supply is the problem, or if your baby is simply not nursing enough/efficiently enough, or if it’s a combination of the two.

Assuming latch is now effective and does not hurt you, you know how to increase production. let/encourage baby to nurse more. even short sessions. even sessions that come one right after the other with no break or sleep by baby in between. Even if baby keeps popping off and on. A baby this age is typically quite distractible and often fussy at the breast. Baby does not need to sleep after every nursing/feeding session to show they are satisfied. my three month old fussed for hours last night and nursed and nursed despite the fact she had gotten so much she was spitting it up! fussiness does not always equal baby needing more. Also, needing to cluster feed is still normal. Assuming milk transfer is happening, its very simple-the more baby nurses, the less you will need to pump and the less you will need to supplement. That is the very possible road off that truly exhausting pump/supplement/nurse treadmill.

But, if you decide you cannot keep trying to increase your supply, combination feeding may work for you, certainly any breastmilk your baby gets and anytime at the breast is good for baby-and for mom too! The studies are clear, breastfeeding need not be all or nothing, benefit wise.

I am sorry your lc is not responsive. but if at this point you are looking for support rather than professional breastfeeding assistance, perhaps you can find that elsewhere. Do you have a local LLL, or mommy and me that is breastfeeding friendly, anything like that?

Re: So confused about weight gain. Dr vs. IBCLC

Hi Mama! I just checked my DD weights and she was 12#7oz at 4.5 months. She was getting about 2-3 oz of formula for about 10 weeks, and then we tossed it. Everyone, strangers especially, comment how small she is. Most of the moms on her can attest to my worry about whether or not something was wrong with me, my milk, etc. It's taken me a long time to come to terms with how my baby is growing - I wish I could have sooner because it would have meant a lot less worry!! I think you can definitely ditch the formula, just put her on the boob as much as possible and pump when you can. You'll get your supply up, no problem!

Re: So confused about weight gain. Dr vs. IBCLC

Originally Posted by @llli*loumom

If I implied that people on these boards were unsupportive, I'm sorry. That's not at all what I meant.

Don't worry about it, mama! Honestly, I think we are extra-sensitive about coming across as critical or unsupportive. So many people out there feel hurt or guilt-tripped by kindly-meant breastfeeding advice! We really don't want to scare someone away, and have them go through the rest of their life thinking "Those La Leche League people are awful. They were so unsympathetic in my hour of need."

One reason why your baby's weight gain may slow when supplementing increases is that formula actually has slightly fewer calories per oz than breastmilk. Another reason might be that formula tends to sit heavy on a little tummy, and babies who eat formula may go longer between feedings.